Provider Demographics
NPI:1689956674
Name:NGO, MIRELA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MIRELA
Middle Name:
Last Name:NGO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MIRELA
Other - Middle Name:
Other - Last Name:SZABO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2936
Mailing Address - Country:US
Mailing Address - Phone:303-586-8417
Mailing Address - Fax:
Practice Address - Street 1:300 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-2936
Practice Address - Country:US
Practice Address - Phone:303-586-8417
Practice Address - Fax:303-586-8423
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19006183500000X
TX46958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist